BMC Anesthesiology最新文献

{"title":"Toxic effects of prolonged propofol exposure on cardiac development in zebrafish larvae.","authors":"Shaojie Qian, Huizi Liu, Hanwei Wei, Jintao Liu, Xiaojun Li, Xiaopan Luo","doi":"10.1186/s12871-025-02942-1","DOIUrl":"10.1186/s12871-025-02942-1","url":null,"abstract":"<p><strong>Background: </strong>Propofol, commonly used as an intravenous anesthetic during pregnancy, can easily penetrate the placental barrier, potentially affecting fetal heart development. This study aims to investigate propofol's impact on developing zebrafish heart structure and function, and identify potential drug targets.</p><p><strong>Methods: </strong>Zebrafish embryos were exposed to different concentrations of propofol (0.5, 1, and 5 mg/L) to observe changes in zebrafish larval heart structure and function (heart rate). In vitro cell experiments were conducted to assess the effects of propofol at different concentrations on cardiomyocyte viability and migration. Transcriptomic sequencing was utilized to identify and validate potential drug targets associated with propofol-induced cardiac toxicity.</p><p><strong>Results: </strong>The results demonstrate that propofol dose-dependently reduces the hatching and survival rates of zebrafish larvae, while increasing the rate of deformities. Transgenic green fluorescent zebrafish larvae exposed to propofol exhibit enlarged cardiac cavities, and HE staining reveals thinning of the myocardial wall. Additionally, propofol-treated zebrafish larvae show a decrease in heart rate. We also assess the impact of propofol on myocardial cell function, showing decreased cell viability, reduced migration function, and increased apoptosis. Finally, transcriptome sequencing analysis and differential gene co-expression network analysis identify agxt2 as a potential target of propofol-induced cardiac toxicity.</p><p><strong>Conclusion: </strong>In conclusion, our study indicates that propofol alters the structure and function of the developing zebrafish heart, with the mitochondrial-related gene agxt2 possibly being a target of its pharmacological effects.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"81"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guideline recommendations on the assessment and management of awake airway intubation: a systematic review.","authors":"Fei Chen, Zhimin Tan, Qiyu He, Qian Li","doi":"10.1186/s12871-025-02940-3","DOIUrl":"10.1186/s12871-025-02940-3","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically appraise the quality of clinical practice guidelines (CPGs) regarding awake tracheal intubation (ATI) and to compare the consistency of common recommendations.</p><p><strong>Design: </strong>Systematic review, critical appraisal and narrative synthesis of CPG recommendations for ATI.</p><p><strong>Methods: </strong>A systematic search of the PubMed, EMBASE, Cochrane, Web of Science, and Scopus databases was conducted up to July 1, 2024, to identify up-to-date CPGs. The AGREE II (Appraisal of Guidelines for Research and Evaluation) checklist was used to critically appraise the CPGs. Interrater agreement was determined via intraclass correlation coefficients (ICCs) with a two-way random effects model for each domain and overall rating score. All the suggestions extracted from the included guidelines were sorted and analyzed and summarized via the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.</p><p><strong>Results: </strong>Our study resulted in 939 records and ultimately 7 CPGs were appraised. The content of these CPGs covered six themes of ATI: indications, airway local anesthesia, the intubation procedure, checking the tube position, management after ATI failure, and the extubation process. When the AGREE II tool was used to appraise CPGs, only 3 CPGs were rated as \"high\" quality. With the exception of domain 1, we observed good agreement in all five other domains (ICCs over 0.7). These CPGs provided relatively consistent recommendations and evidence on intubation procedures and checking tube position. In terms of indications and airway local anesthesia, there was controversy. Twenty-nine recommendations regarding ATI were summarized through the GRADE system, among which 16 were considered relatively reliable.</p><p><strong>Conclusion: </strong>Through the AGREE II tool and the GRADE system, the strengths and weaknesses of each CPG were comprehensively analyzed on the basis of its scientific validity and practicability. Moreover, the limitations of the current CPGs in terms of indications, airway local anesthesia and complex clinical situations are presented, and clinicians are encouraged to apply the guidelines more scientifically and to update and improve the guidelines.</p><p><strong>Systematic review registration: </strong>CRD4202458548 (PROSPERO).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"79"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photoplethysmography parameters in monitoring nociception during general anesthesia.","authors":"Hua Li, Yingying Tang, Xiaoping Chen, Mengge Zhang, Feng Jiang, Fangfang Zhu, Linghua Xie, Hui Wu, Qi Xu, Qing Chen, Shulan Xie, Ange Dai, Xinzhong Chen","doi":"10.1186/s12871-025-02932-3","DOIUrl":"10.1186/s12871-025-02932-3","url":null,"abstract":"<p><strong>Background: </strong>Validated monitoring methods for evaluating the balance of nociception and anti-nociception (BNAN) are needed in general anesthesia. This study assessed six photoplethysmography (PPG) parameters, computed from finger photoplethysmographic waveforms in patients undergoing gynecological surgery under general anesthesia.</p><p><strong>Methods: </strong>A total of 20 participants were included, each undergoing general anesthesia with propofol and remifentanil. The same concentration of remifentanil was maintained throughout the experiment, four different intensities of electrical stimulation were administered, and the patient's fingertip PPG was meticulously recorded. PPG data were preprocessed to extract six PPG morphological parameters, and photoplethysmographic amplitude (PPGA), pulse beat interval (PBI), and surgical pleth index (SPI). Receiver operating characteristic (ROC) curves and the Area Under the Curve (AUC) were constructed and calculated to accurately measure its ability to reflect the nociceptive stimulus state. The consistency of different phase parameters at different stimulus intensities was evaluated by calculating the prediction probabilities. All results were compared with those obtained using SPI, PPGA, and PBI.</p><p><strong>Results: </strong>After stimulation, all parameters and SPI showed significant changes compared with those before stimulation (p = 0.000). The catacrotic phase parameters (AC and MHC) showed higher discrimination in adequate analgesia and congruence with electrical stimulation intensity than the overall phase parameters, PPGA, and anacrotic phase parameters (AC: AUC = 0.851, Pk = 0.800; MHC: AUC = 0.837, Pk = 0.792).</p><p><strong>Conclusions: </strong>In this study, six PPG morphological parameters were proposed and observed for the first time to effectively distinguish the occurrence of nociception. Compared with the overall phase parameters, PPGA, and anacrotic phase parameters, catacrotic phase parameters were more capable of characterizing noxious stimuli and more consistent with changes in electrical stimulation intensity.</p><p><strong>Trial registration: </strong>ChiCTR2200062228; Registered at http://clinicaltrials.gov on July 30, 2022.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"78"},"PeriodicalIF":2.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional anesthesia for pediatric cardiac surgery: a review.","authors":"Burhan Dost, Alessandro De Cassai, Sara Amaral, Eleonora Balzani, Yunus Emre Karapinar, Müzeyyen Beldagli, Mirac Selcen Ozkal Yalin, Esra Turunc, Ali Ahiskalioglu, Serkan Tulgar","doi":"10.1186/s12871-025-02960-z","DOIUrl":"10.1186/s12871-025-02960-z","url":null,"abstract":"<p><strong>Background: </strong>Effective pain management in pediatric cardiac surgery is essential for optimizing postoperative outcomes and promoting faster recovery. While intravenous analgesia remains a standard approach, regional anesthesia (RA) techniques have gained attention in this population due to their analgesic efficacy, reduced dependence on systemic opioids, and enhanced hemodynamic stability.</p><p><strong>Main body: </strong>This article provides an overview of current evidence of RA techniques for pediatric cardiac surgery. We discuss the role of RA in pediatric pain management, outlining various techniques, such as epidural, paravertebral block, fascial plane blocks and their specific applications, clinical outcomes, and the challenges posed by pediatric anatomy and pharmacokinetics. Pain assessment in pediatric populations and the complications associated with RA are also explored.</p><p><strong>Conclusion: </strong>Despite the demonstrated efficacy of RA in this patient group, there is a need for large-scale randomized multicenter studies to establish standardized protocols and strengthen the evidence base for its use in pediatric cardiac surgery.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"77"},"PeriodicalIF":2.3,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhalational versus intravenous anesthetic for cerebrovascular accident outcomes after surgical revascularization for adult moyamoya disease.","authors":"Yifei Cheng, Chaochao Zha, Xuehua Che, Yingwei Wang","doi":"10.1186/s12871-025-02958-7","DOIUrl":"10.1186/s12871-025-02958-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of inhalational anesthetics and intravenous anesthetics on the neurological function of patients with moyamoya disease (MMD) after vascular bypass surgery.</p><p><strong>Methods: </strong>The clinical anesthesia data of patients were retrospectively collected. Patients who underwent bypass grafts with general anesthesia from January 1st, 2019, to December 31st, 2020, in Huashan Hospital affiliated with Fudan University, were selected. The primary endpoint was stroke incidence within seven days after anesthesia, and the secondary endpoints included transient neurological deficits (TNDs) and incidence of postoperative Epilepsy.</p><p><strong>Results: </strong>We compared the data of MMD patients who received inhalational anesthetics (Sevoflurane anesthetics, n = 197, group S) and intravenous anesthetics (Propofol anesthetics, n = 219, group P). The stroke incidence in the two groups (group S vs. group P) was 6.6% vs. 5.9% (OR = 0.893; 95% CI, 0.404-1.976; p = 0.780), and the group S vs. group P of TNDs incidence was 32.5% vs. 31.1% (OR = 0.936; 95% CI, 0.619-0.1.415, p = 0.753). At discharge, anesthetics didn't affect the neurological endpoint. Intravenous anesthetics provided patients with better hemodynamics compared with inhalational anesthetics during MMD vascular bypass surgery (group S vs. group P, ARV_SBP: 6.4 vs. 5.2, p < 0.001, ARV_DBP: 3.9 vs. 3.3, p = 0.002, ARV_MBP: 4.5 vs. 3.8, p = 0.001,). There were statistical no differences in the NHISS score (S group vs. P group = 2:1, p = 0.082) at 7 days after surgery, but mRS score (S group vs. P group = 2:1, p < 0.001) at 7 days after surgery, as well as the mRS score at 6 months of follow-up (S group vs. P group = 0:0, p < 0.001), although the difference in scores was small.</p><p><strong>Conclusion: </strong>Our data indicated that both inhalational and intravenous anesthetics had protective effects on patients who underwent MMD bypass grafts. MMD patients who received inhalational anesthetics and intravenous anesthetics had similar odds of neurological deficits. When comparing long-term clinical data, most patients experience good neurological recovery after receiving inhalation or intravenous anesthesia, when compared p₇₅ mRS score(S group vs. P group = 3:1)in 6 month indicate that intravenous anesthetics might be more suitable for patients undergoing MMD bypass grafts. During the operation hemodynamic stability in the propofol group is greater than that in the sevoflurane anesthesia group.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"76"},"PeriodicalIF":2.3,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of preoperative dexmedetomidine administration on the bispectral index in children during sevoflurane inhalation anesthesia: a randomized controlled trial.","authors":"Zhen Xiang, Lei Wu, Siwei Wei, Eryou Yu, Zheng Chen, Zhen Du","doi":"10.1186/s12871-025-02946-x","DOIUrl":"10.1186/s12871-025-02946-x","url":null,"abstract":"<p><strong>Background: </strong>The available data on the effect of dexmedetomidine premedication on anesthesia depth in children during general anesthesia are limited. This study was designed to determine the effect of preoperative dexmedetomidine administration on the bispectral index (BIS) and sevoflurane requirements in children during sevoflurane anesthesia.</p><p><strong>Methods: </strong>120 children aged 5 to 12 years undergoing concealed penis repair or hypospadias plastic surgery were randomized to receive preoperative administration of 0.25 µg kg^- 1 dexmedetomidine, 0.5 µg kg^- 1 dexmedetomidine, 0.75 µg kg^- 1 dexmedetomidine, or the same volume of placebo. The primary outcome was the change in the BIS value from before dexmedetomidine administration to 60 min after surgical incision. The secondary outcomes included the end-tidal sevoflurane concentration (ETsevo), hemodynamic data, anesthesia recovery data and intraoperative awareness.</p><p><strong>Results: </strong>Compared with those in Group C, the BIS values of children in Group D2 and Group D3 were significantly lower during sevoflurane induction and early maintenance (P < 0.017). Moreover, children in Group D2 and Group D3 had a lower ETsevo (P < 0.001) during sevoflurane maintenance than did those in Group C (P < 0.017). There were statistically significant differences in heart rate(P < 0.0001) and mean arterial pressure(P < 0.001) between the groups, but the incidence of bradycardia or hypotension was similar between the groups (p = 0.779 and p = 0.901).</p><p><strong>Conclusions: </strong>Children who received 0.5 µg kg^- 1 or 0.75 µg kg^- 1 dexmedetomidine preoperatively were more likely to achieve the target depth of anesthesia (BIS less than 60) during anesthesia induction and had lower BIS values during the early stage of anesthesia maintenance.</p><p><strong>Trail registration: </strong>The trial is registered with the China Clinical Trials Registry Registration Number: ChiCTR1900026872. Date of registration: 10/24/2019.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"72"},"PeriodicalIF":2.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the inferior vena cava collapsibility index in predicting propofol-induced hypotension in patients undergoing colonoscopy.","authors":"Zhou Zhou, Yujie Li, Jinxian Zhu, Yingge Liu, Yuxin Wang, Xiaoqiao Sang, Xinxin Wang, Xiaobao Zhang","doi":"10.1186/s12871-025-02945-y","DOIUrl":"10.1186/s12871-025-02945-y","url":null,"abstract":"<p><strong>Background: </strong>Hypotension is a common side effect of propofol induction, and when severe, it is associated with adverse outcomes. Ultrasonography of the inferior vena cava (IVC) is a reliable indicator of the intravascular volume. This study investigated whether preoperative IVC ultrasound measurements could predict hypotension after propofol induction in patients undergoing colonoscopies.</p><p><strong>Methods: </strong>Sixty-two adult patients with American Society of Anesthesiologists physical status (ASA) I-II scheduled for colonoscopy after propofol induction were recruited. The Ultrasound Maximum IVC diameter (dIVCmax), minimum IVC diameter (dIVCmin), and collapsibility index (IVC-CI) were assessed in all patients before propofol induction. Mean blood pressure (MBP) was recorded before induction. Propofol was injected intravenously after ultrasound measurements. MBP was recorded 1, 3, 5, and 10 min after propofol induction. The receiver operating characteristic (ROC) curve of IVC-CI was compared with that of patients who developed hypotension after propofol induction.</p><p><strong>Results: </strong>Sixty-two patients completed the study, and their data were considered for statistical analysis. After induction,30 patients developed hypotension. The area under the curve (95% confidence interval) was 0.72 (0.595 to 0.849) for IVC-CI. The optimal IVC-CI cutoff value was 38.25%, with a sensitivity of 56.7% and specificity of 71.9%. IVC-CI before induction strongly correlated with the maximum percentage of MBP drop after propofol induction. (regression coefficient = 0.33, P = 0.008), respectively.</p><p><strong>Conclusion: </strong>Pre-induction IVC-CI > 38.25% is a non-invasive predictor of propofol-induced hypotension in patients undergoing colonoscopy and is strongly correlated with MBP drop.</p><p><strong>Trial registration: </strong>This clinical trial was approved by the Ethics Committee of The Affiliated Lianyungang Hospital of Xuzhou Medical University (YJ-20190529001). All the study procedures were performed in accordance with the ethical standards of the Helsinki Declaration of 2013.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"73"},"PeriodicalIF":2.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Safety of Opioid-Free Anaesthesia and Analgesia in pain control and postoperative recovery of patients undergoing gynaecologic oncologic surgery: a retrospective cohort study.","authors":"Jose Alexander Puentes Garcia, Daniel Rivera Tocancipa, Eugenio Medina, Julián Jovel Díaz, Pisso, Vincent Jean Carlo García Gil, Fredy Leonardo Carreño Hernandez","doi":"10.1186/s12871-024-02867-1","DOIUrl":"10.1186/s12871-024-02867-1","url":null,"abstract":"<p><strong>Background: </strong>Opioids have been essential for the anesthesiologic management of patients undergoing surgical procedures such as gynecologic oncology, but incorrect dosage can lead to unwanted hemodynamic effects. Opioid-free anesthesia (OFA) and multimodal postoperative analgesia techniques can solve this problem as they can restrict the excessive use of opioids.</p><p><strong>Methodology: </strong>A retrospective observational cohort study was conducted by reviewing the medical records of patients at the Hernando Moncaleano Perdomo University Hospital. Female patients who underwent gynecologic oncology surgery at the MPUHN and who received OFA, or opioid-based anesthesia (OBA) were identified. Two cohorts were created in which one have all patients (unadjusted cohort) and one with randomly selected patients (adjust cohort). Data on pain were collected using a visual analog pain scale (VAPS), along with hemodynamic variables and adverse events at 7 different times from admission to the operating room until discharge from the hospital. A bivariate analysis was performed between OFA and OBA, comparing frequencies of VAPS and adverse events with chi2, while mean difference for hemodynamic variables with t student. A multivariate analysis was performed with multiple logistic regression to evaluate differences in frequency of VAPS between OFA and OBA.</p><p><strong>Results: </strong>For unadjusted cohort, difference was identified for greater pain in OFA than in OBA (p < 0.001) for the times before surgery, recovery room, and 24 h after surgery, while differences were only identified at recovery room in the adjusted cohort. The heart rate has significant differences only at pre-surgery, 30 min of induction and admission to the recovery room. Respiratory rate has significant differences at admission to the operating room, 30 min of induction. Mean arterial pressure was significant only in the recovery room and for oxygen saturation at admission to the operating room and discharge from recovery. Higher frequency of requiring antiemetics was only identified in patients with OFA than OBA on the fifth day of surgery. Significance was identified in multivariate analysis between OBA and OFA for at discharge from recovery room.</p><p><strong>Conclusions: </strong>The OFA technique for gynecologic oncologic surgery patients has a similar impact on pain control compared to OBA.</p><p><strong>Trial registration: </strong>Does not apply.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"75"},"PeriodicalIF":2.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A modified approach of combined anterior lumbar plexus block with lateral sacral plexus block in a semi lateral supine position for lower limb fracture patients: a case series.","authors":"Heyu Ji, Xulei Cui","doi":"10.1186/s12871-025-02943-0","DOIUrl":"10.1186/s12871-025-02943-0","url":null,"abstract":"<p><p>Lumbar plexus block (LPB) and sacral plexus block (SPB) are commonly used regional anesthesia techniques for lower limb surgeries. We propose a novel approach combining anterior LPB and lateral SPB in a semi-lateral supine position with a pad under the upper body. This approach minimizes discomfort and pain during position changes, enhances probe manipulation space, and aids in maintaining aseptic conditions throughout the entire operation. In a study involving 9 elderly patients undergoing hip surgery for femoral neck fractures, we used this modified anterior LPB and lateral SPB technique. Prior to the regional anesthesia, patients were sedated with dexmedetomidine, and the lumbar plexus and sacral plexus were localized using dual guidance techinques, including ultrasound and electrical nerve stimulation. This case series demonstrates the effectiveness of the modified approach, significantly minimizing pain and discomfort associated with positional changes, and is a promising modification to the classical approach. TRIAL REGISTRATION NUMBER: NCT05901415.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"74"},"PeriodicalIF":2.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the effects of magnesium sulfate and lidocaine spray on hemodynamic changes caused by laryngoscopy and tracheal intubation: a randomized clinical trial.","authors":"Marzieh Khalaji, Mohadese Babaie, Fatemeh Bayat, Mehdi Rezaee, Banafsheh Mashak","doi":"10.1186/s12871-025-02962-x","DOIUrl":"10.1186/s12871-025-02962-x","url":null,"abstract":"<p><strong>Aim: </strong>This study aims at comparing the impact of Magnesium Sulfate and Lidocaine sprays on hemodynamic changes after laryngoscopy and tracheal intubation.</p><p><strong>Design: </strong>This double-blind clinical trial (code IRCT20230719058846N1) was conducted on the patients undergoing elective surgery in the city of Karaj.</p><p><strong>Methods: </strong>A total of 100 patients, aged 18 to 40 years and classified as ASA I or II, who were candidates for elective surgery, were randomly assigned to two equal groups. Prior to intubation, patients received lidocaine spray (5 puffs of Lidocaine 10%) in one group, and magnesium sulfate spray (5 puffs of Magnesium 20%) in the other. Induction of anesthesia was the same in both groups. Patients' hemodynamic statuses were measured and compared once before the intubation and also 1, 3, 5, 7 and 10 min after it.</p><p><strong>Results: </strong>Before the intervention, there was no statistically significant difference between the two groups in terms of demographic and hemodynamic variables (P < 0.05). The results showed that the systolic blood pressure at minutes 3, 5, and 7 was significantly lower among the patients receiving magnesium than those receiving lidocaine (P < 0.05). Other hemodynamic variables were not statistically different between the two groups (P < 0.05).</p><p><strong>Conclusion: </strong>Based on the findings of the present study, magnesium sulfate spray is more effective than lidocaine in controlling hemodynamic complications. Therefore, it can be used to reduce hemodynamic complications following intubation. However, it may be associated with tachycardia, which needs to be taken into account.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"71"},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}